title: Sentinel node identification using technetium-99m neomannosyl human serum albumin in esophageal cancer.
abstract: BACKGROUND
  This study is a clinical trial designed to test the reliability and feasibility of sentinel node detection using a new mannose receptor radioactive binding agent in patients with esophageal squamous cell carcinoma.
  
  
  METHODS
  Twenty-three patients (21 men, 2 women; mean age 61.0±8.60 years) who were candidates for esophagectomy with conventional lymph node dissection for thoracic esophageal cancer were enrolled. A total dose of 1 mCi of 99mTc-MSA [technetium-99m neomannosyl human serum albumin] in 0.2 mL was administered at 4 quadrants into the submucosal layer around the primary tumor under esophagoscopic guidance approximately 1 hour before surgery. Intraoperative sentinel node sampling was subsequently followed by esophagectomy. All harvested lymph nodes were cut into 2-mm slices and ultimately diagnosed using formalin-fixed and paraffin-embedded sections with hematoxylin and eosin staining.
  
  
  RESULTS
  The number of dissected lymph nodes per patient was 30.5±9.18 (15-47). Among 23 patients, the sentinel lymph nodes could be identified in 21 patients (91.3%). The sentinel nodes could be identified in all 21 patients with cT1 or T2N0M0 (100%) disease; these patients were candidates for sentinel lymph node navigation surgery for the esophageal cancer. The mean number of sentinel nodes identified was 2.6±1.35 (range, 1-5) per patient. No false-negative sentinel lymph nodes were detected in any of the 8 patients with node-positive disease (0%).
  
  
  CONCLUSIONS
  Intraoperative sentinel lymph node identification using 99mTc-MSA was feasible and reliable in patients with esophageal squamous cell carcinoma.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, and Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Hyun Koo
authors.initials: HK
authors.lastname: Kim
authors.forename: SeungEun
authors.initials: S
authors.lastname: Kim
authors.forename: Jong Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Jeong
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Mok
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Choi
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000379:methods* / Q000401:mortality; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D016019:Survival Analysis; D013668:Technetium Tc 99m Aggregated Albumin; D016896:Treatment Outcome
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin